Provider Demographics
NPI:1073121018
Name:TRAN, KRISTINA (FNP-C)
Entity Type:Individual
Prefix:
First Name:KRISTINA
Middle Name:
Last Name:TRAN
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:650 N OAKLAND AVE APT 303
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101-1156
Mailing Address - Country:US
Mailing Address - Phone:626-662-3834
Mailing Address - Fax:
Practice Address - Street 1:650 N OAKLAND AVE APT 303
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-1156
Practice Address - Country:US
Practice Address - Phone:626-662-3834
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-15
Last Update Date:2021-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP95013297363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily